The month of November is being celebrated as Bladder health awareness month in India to create awareness of bladder health. Experts on this occasion call on women not to suffer urinary leakages silently, which could lead to severe complications.

Dr Rubina Shanawaz, Consultant Gynecologist, at Fortis Hospital, stated that one in four women in India above the age of 35 faces some kind of urinary leakage.

The common misconception is that it is a part of having given birth to children and due to the ageing process. Also, it is a fact that women are embarrassed to bring it up to their families and seek treatment options for the same, she said.

In Bangalore, the increased incidence of chronic cough owing to allergies leads to more women suffering from urinary leakage on coughing. Another factor is the increased body mass index owing to a sedentary lifestyle which puts pressure on the urinary bladder leading to embarrassing leaks, Dr Rubina explained.

Women suffering from diabetes present with constant visits to the restroom with dribbling of urine which is due to the nerve supply to the bladder being affected by high blood sugar values, she noted.

"Most women who approach us are used to managing the issue with sanitary napkins or diapers. They also broadly restrict their lifestyle and avoid getting out of the house to prevent embarrassing urinary leaks and the odour associated.

Long-term suffering in silence without treatment can lead to vulval skin excoriation, urinary tract infections, and back pressure effects on the kidney, especially in diabetics," she stated.

"Utmost importance needs to be given to eliciting the appropriate history from the patient to arrive at the exact issue contributing to the lack of control of the urinary bladder.

The need of the hour is increased awareness among women and their caregivers on the effects of urinary leaks and the treatment options available for the same," Dr Rubina said.

Dr P. Vamsi Krishna, HOD and Senior Consultant, department of urology, CARE Hospitals, Banjara Hills, Hyderabad stated that "Regardless of the gender, around 20-25 per cent of people have issues with bladder health in India."

While the need to treat urological infections is very high, patients do not find the right help or guidance for the treatment. Women are hesitant to seek medical care due to the social stigma and taboo that is persistent in our country. There is huge awareness required regarding urinary infections and their urgent treatment, he explained.

Dr P. Vamsi Krishna further explained that one in four women have urinary infections, with a lifetime risk of it. A female's urinary tract is only 3-4 cm wide and of very short length. After sexual intercourse, or when the woman is in her reproductive age, she is highly prone to these infections due to the short urethra.

Once the woman enters her menopausal phase, due to the physical dryness, replaced additional poor hormonal activity, and estrogen deficiency in the vaginal area, the body's immunity is naturally immunity lowered and increases the risk of infection due to ageing, he stated.

Dr P. Vamsi Krishna stated, there is also an increase in urinary incontinence in India, and the ratio is higher in women due to the shorter length of their urinary tract.

There are two types of incontinence - stress urinary incontinence which is caused due to laxity in the urethra and, urgency incontinence which is due to an overactive or irritable bladder and does not let you control your urine, he stated.

When the tissues around the urethra become loose or lax a person won't be able to hold their urine. Diabetes is one more catalyst for an overall infection of the body which causes an irritable bladder, he said.

Dr P. Vamsi Krishna says that for further treatment and prevention, one should take an adequate course of antibiotics with a minimum of 5-7 days as prescribed by the doctor.

Many times, as the antibiotic course is inadequate, the patients face residual and persistent infection and require a prolonged antibiotic course. Females should empty their bladder after physical intercourse, he stated.

Elderly ladies should check for diabetes. The patients with stress continency are advised kegel exercises. One should accordingly address these issues further after checking for these underlined issues, as prescribed by your doctor, he said.

Dr Sreeharsha Harinatha, Consultant Urology, Uro-oncology, Andrology, Transplant and Robotic Surgery, Fortis Hospital, Bannerghatta Road, Bangalore stated that 25 to 45 per cent of adult women report occasional leakage.

Urinary leakages are more common in women than in men. Awareness about urinary leakage is a must as women are hesitant to talk about their leak condition. 80 per cent of those affected with urinary leakage can be improved or cured.

There are various factors that can cause urinary leaks like obesity, childbirth, high-impact exercise, caffeine or alcohol consumption and co-morbidities such as diabetes, urinary tract infection and heart diseases, as per Dr Sreeharsha Harinatha.

It is vital that one understands the types of urinary incontinence - bladder leaks during exercise, coughing, sneezing, laughing which puts pressure or stress on the bladder, sudden urge to pass urine, and having an overactive bladder.

However, leakage can be prevented by following certain measures like limiting caffeine intake, stopping smoking, weight loss, physical therapy and biofeedback, he explains. For those in whom lifestyle modifications do not provide adequate relief, they would require further evaluation with tests such as urine analysis, ultrasound pelvis and Urodynamic study, he said.

Treatment is tailored to individual patient needs and expectations based on symptoms and aforementioned test results, Dr Harinatha stated.